Over the past year, we've made the Blood Chemistry Calculator our primary screening and feedback tool for the athletes we work with. In that time we've noted some clear patterns in the effects of long-term and vigorous exercise on blood chemistry. We've learned that while certain tests seem to be directly affected by hard training sessions, some can also provide clues for how best to enhance athletic performance.

In this podcast I'm talking with Dr Tommy Wood, MD, PhD about blood chemistry in athletes: which markers are affected by intense exercise, how to know if your labs indicate a problem, and what to do about it. We discuss the markers associated with athletic power and lifespan, and why knowing your own blood chemistry numbers may be the best thing you do for your health and performance.

Here's the outline of this interview with Tommy Wood:

[00:01:24] Liver enzymes (ALT, AST).

[00:04:44] Optimal vs standard reference ranges.

[00:06:28] Differences among ethnic groups.

[00:08:15] Recovery of liver enzymes after exercise; Study: Pettersson, Jonas, et al. "Muscular exercise can cause highly pathological liver function tests in healthy men." British journal of clinical pharmacology 65.2 (2008): 253-259.

[00:10:40] Creatinine.

[00:12:22] Podcast: How to Entrain Your Circadian Rhythm for Perfect Sleep and Metabolic Health, with Greg Potter; HumanOS Podcast.

[00:12:52] Creatinine vs creatine.

[00:13:36] Creatine monohydrate; Creapure Creatine; Douglas Labs Creatine Monohydrate.

[00:14:12] Blood Chemistry Calculator; Predicted Age Score.

[00:15:53] Creatinine - U shaped curve.

[00:16:54] Creatinine and kidney function.

[00:17:44] Battle of the quads: Robert Forstemann vs. Andre Greipel.

[00:18:13] Hematocrit.

[00:18:42] Blood doping.

[00:18:44] Book: The Secret Race: Inside the Hidden World of the Tour de France, by Tyler Hamilton.

[00:19:22] Higher hematocrit = higher power.

[00:20:15] Adaptations that reduce hematocrit.

[00:21:48] Testosterone.

[00:23:27] MCV, RDW.

[00:24:39] Reticulocytes.

[00:26:02] Grigory Rodchenkov; World Anti-Doping Agency.

[00:26:23] Podcast: How to Identify and Treat Relative Energy Deficiency in Sport (RED-S), with Nicky Keay.

[00:26:33] Blood Urea Nitrogen (BUN).

[00:27:40] Dr. Tamsin Lewis; Causes of a high BUN.

[00:31:54] Higher RDW = increased risk of mortality.

[00:34:34] Triglycerides ideally

[00:34:44] Fasting blood glucose - once past 110 not much change in mortality risk.

[00:35:44] Blood glucose and biological age.

[00:36:49] High fasting blood glucose in athletes.

[00:38:35] Machine learning to identify diabetic retinopathy; Study: Gulshan, Varun, et al. "Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs." Jama 316.22 (2016): 2402-2410.

[00:40:51] Calcium; lower levels in athletes.

[00:42:26] Podcast: Optimal Diet and Movement for Healthspan, Amplified Intelligence and More with Ken Ford; Grip strength; Study: Fain, Elizabeth, and Cara Weatherford. "Comparative study of millennials' (age 20-34 years) grip and lateral pinch with the norms." Journal of Hand Therapy 29.4 (2016): 483-488.

[00:43:25] Article: Optimizing Vitamin D for Athletic Performance, by Brad Dieter, PhD with contributions from Tommy Wood, MD and Christopher Kelly.

[00:43:46] Cholesterol levels in athletes; Study: Creighton, Brent C., et al. "Paradox of hypercholesterolaemia in highly trained, keto-adapted athletes." BMJ open sport & exercise medicine 4.1 (2018): e000429.

[00:43:50] Podcast: How to Drop Your Cholesterol, with Dave Feldman.

[00:44:40] Higher cholesterol = higher lifespan. Studies: 1. Stückle, Druckerei. "Towards a Paradigm Shift in Cholesterol Treatment. A Re-examination of the Cholesterol Issue in Japan: Abstracts." Annals of Nutrition and Metabolism 66.Suppl. 4 (2015): 1-116 and 2. Ravnskov, Uffe, et al. "Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review." BMJ open 6.6 (2016): e010401.

[00:46:04] How often to run a blood test for an athlete?

[00:47:02] Elite Performance Program (EPP); Patreon; Elite Performance Members Club Forum.